| NPI | 1366974198 |
|---|---|
| Former Name | SAMANTHA LYNN HAGGERTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.141505) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 283767) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2024-03-21 |